? My cat is on 4 units Lantus. Afraid vet will want him to go immed. to 5 units. HELP!

lovemycat444

lovemycat444

Member Since 2017
Hi all, first of all I seriously respect everyone who does and maintains the blood glucose curve testing spreadsheets. I'm terrible at math, and I can't seem to understand how to keep a spreadsheet. Can someone please help me navigate the sheets and explain to me how to do it. I've read the how to page but I got confused.

I test my cat every few months, doing a on the 3 hour mark, a ear prick blood test with an Alphatrak.
I just wrote this message to my vet. (below)

My cat's vet is fantastic, she's been so attentive and caring for my cat's diabetes. But I'm worried that she will want him to go up a full unit. He's currently on 4 units, but his BG was very high about 6 months ago she had him go up to 5 units. I'm concerned that is too fast of an increase of Lantus, going from 4 units straight to 5 units.

Also, it's very difficult to give my cat the ear prick blood test. He absolutely hates it and gets highly agitated and scared immediately. He's 16 lb's and can be very strong when he's afraid. A friend always has to help me hold him in a kitty burrito wrapped in a towel so I'm able to do the ear prick.

I'm unsure if his blood glucose spikes when he's getting tested because he gets so frightened by the test. I'm hoping his BG numbers are as accurate as possible.

This is the message I emailed to the vet tonight:

I'd noticed I think for approximately 2 months now he's been drinking water excessively, definitely more than when his Diabetes has been very well regulated. He also seems to be hungrier than usual.

He had his first Insulin shot at 2 pm today, Monday.

Is it safe to give him his next shot at 1:00 am late tonight, then tomorrow, Tuesday his morning shot at 12pm, and his evening shot at 11pm. Basically bringing him back to I've had him on an 11am and 11pm Insulin shot schedule. I'm not sure if that's too rapid.

Can you please tell me, should his ideal blood glucose be between 120-180?

Taco ear prick test: bood glucose Monday Sept. 24, 2018

10:00 am approximately gave him wet food, he ate more than usual, he usually eats 1/4 of the can, he ate more than half of the can.

2:00 pm approximately is when he ate a little more than a handful of dry food

2:15 pm approximately when he had 4 units of Lantus Insulin, first shot of the day

Time of BG and BG number

2:30 pm 269

3:35 pm 275

4:30 pm 374

5:30 pm 324

6:30 pm 334
 
lovemycat444 said:
Can someone please help me navigate the sheets and explain to me how to do it.
Click to expand...

The AMPS is the AM Pre-Shot....the test you should get before feeding/Shooting in the morning.

PMPS is the PM Pre-Shot

U is for Units ….how much you give

After the AMPS, you start the "+ cells"......each cell corresponds to the number of hours since the last shot.....so if you shoot at 11am and get a test at 2pm, that's 3 hours after the shot, so the test number would go in the +3 cell....if you tested again at 6pm, that's 7 hours after the shot, so would go in the +7 cell......it goes all the way up to +11 and then the next cycle starts and it all starts over!!

lovemycat444 said:
Is it safe to give him his next shot at 1:00 am late tonight, then tomorrow, Tuesday his morning shot at 12pm, and his evening shot at 11pm. Basically bringing him back to I've had him on an 11am and 11pm Insulin shot schedule. I'm not sure if that's too rapid.
Click to expand...

We don't suggest going quite that fast....If you need to work your way back to a certain time, we suggest doing it 15 minutes per cycle or 30 minutes per day

lovemycat444 said:
Can you please tell me, should his ideal blood glucose be between 120-180?
Click to expand...

Normal blood glucose for cats is 50-120 on a human meter....68-about 150 on a pet meter. Most vets will want you to keep them higher though because of their fear of hypoglycemia, but as long as you're testing, you are in control!!
 
Hi and welcome to Lantus and Levemir Land, the nicest place you never wanted to be.

It's wonderful that you are home testing. That's the best way to keep your kitty safe. What is his name, by the way? It would be helpful if you could put that in the signature block, so we don't have to call him "your kitty" all the time.

If you have trouble getting the SS set up, someone can help you do it. Chris has given you a wonderful explanation of the columns. The comments section on the end of each line is very useful for noting anything special, like if he ate more than usual, or less, or peed excessively, etc. You can look at other people's spreadsheet to get a feel for what people put there. Basically, it's to help you and anyone trying to help you see what things might have influenced the numbers that day.

You say you have been testing every few months. Shooting insulin without testing first can result in a hypoglycemic incident - you have no way of knowing if his BG is high enough for it to be safe to give insulin. Also, Lantus dosing is based on how low the dose takes the BG. If you only test one day every few months, you don't know how low he is going the other days. With so little data and increasing the dose by whole units, you could have skipped over a good dose and not know it. I know you love your vet, but it does sound like she doesn't have a lot of experience with FD, and/or with Lantus. This is not uncommon in many otherwise wonderful vets. They actually only get a few hours of study on diabetes in vet school, and that covers both cats and dogs. When you think about it, vets have to learn about a lot of different diseases and conditions in multiple species, so it's not surprising that they are rarely experts in any single one. I am not criticising your vet, just explaining why she may not be giving you the best advice about FD.

There are lots of reasons cats get stressed out about testing, and there are ways to help accustom them to it. First, you need to try keep yourself calm, as the cat can feel your stress (I know, easy for me to say, right?). Try just touching his ear without poking, and if he lets you, give him a treat. Freeze dried meats work great for this - hopefully you can find one he is not allergic to (if not, a smidge of food will work). You want him to associate having his ear touched with something good. Once he is comfy with this, you can move on to poking. Give him a treat every time, even if you don't get blood or aren't able to get a reading. Warming the ear first can help - put some uncooked rice in a sock and heat it in the microwave for up to 30 seconds (test it on your wrist like baby formula). Hold it behind the ear for a little while. I always kept it there while I poked, to keep the ear steady. After the test, rub a little neosporin gel with pain relief on the ear. It will help take the sting away, and next test the blood will bead better. Here is a post with these and other tips to help with testing: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/ Don't give up. You can do this.

Does he have to have the dry food because of his allergies, or would just the wet food work? Dry food is very high in carbs, and that can affect the BG. It can also contribute to constipation, by the way, as it has to draw moisture from the body to be digested. There are several low carb canned foods that contain duck - the Royal Canin is 17% carbs, which is pretty high. Here is a list, put together by a vet, of most commercial cat foods that shows their carb percentages. You want something under 10%, like Nutro's Max Cat With Savory Duck. Don't know if you've already tried other proteins like venison or rabbit, but you'll find some low carb foods with them on there, too. They are also less expensive than "prescription" food.

If you haven't already read the stickies at the top of the page, I highly recommend doing it. There's a lot of info there and it can be very overwhelming, but there are lots of people here that will be happy to answer any questions you have. We love to help!
 
Wow, thank you SO much Tricia. I really appreciate all your help, information, insights and for your time! I learned so much from your response. Taco my cat has been on the selected protein Royal Canin wet and dry food bc he potentially had a bad food allergy. I will read the info about spreadsheets and the stickies. I'm confused with the testing before food. Do I understand correctly, that people here, and yourself do the ear prick blood test everyday twice a day before each am & pm feeding & subsequent insulin shot? Taco's health comes first, a hypoglycemic attack is the first thing I always want to avoid. but I'm afraid that he won't tolerate this testing twice a day, every single day. Is this what yourself and people are able to do? Thanks so much for the help. !!
 
lovemycat444 said:
Do I understand correctly, that people here, and yourself do the ear prick blood test everyday twice a day before each am & pm feeding & subsequent insulin shot?
Click to expand...

Yes....and we also test in between to see how well our cats are responding and how low the Lantus is taking them!

You always test before shooting to make sure they're high enough for insulin at all.....then (if at all possible) test at least once mid-cycle on the AM cycle and at least a "before bed" test on the PM cycle.

Lots of us are "test-a-holics" and test much more often than that!! (Check out the spreadsheets in people's signatures)
 
Thanks for letting me know this. Ok, I'm going to read more of the tips on how to accustomize one's cat to the testing. Taco has not been allowed to have treats bc of his potential food allergy he was on a strict diet of only the selected protein vet prescribed Royal Canin food. So it's been very hard to get him to be not utterly traumatized by the ear prick test, he absolutely hates it. Also, I'm upset to read that it could be causing him pain? The vet and so many other sources said he wouldn't feel any pain from the ear prick test. Thanks again!
 
They learn to tolerate it over time. You need to find a diabetic friendly treat for him such as freeze dried chicken, or turkey, or shrimp. PureBites makes some good ones , no carbs, just protein. They start associating the treat with the poke and some cats will even come willingly to their test spot . Cats are usually very treat motivated. You just have to find the right one that get's his attention. Don't get any of those treats that walmart sells or the grocery store.... those are all high high carb and bad for all cats.
 
What protein was your cat eating before his allergy? Today you have so many choices, there is freeze dried boar, kangaroo, rabbit... you may have to experiment with foods he hasn't eaten before to see if he likes any of them. It takes 6 months to develop a new food allergy so he should be okay with something new to his system.
 
rhiannon and shadow (GA) said:
What protein was your cat eating before his allergy? Today you have so many choices, there is freeze dried boar, kangaroo, rabbit... you may have to experiment with foods he hasn't eaten before to see if he likes any of them. It takes 6 months to develop a new food allergy so he should be okay with something new to his system.
Click to expand...
Great advice. Rhiannon took the words out of my mouth. You might have to do some hunting, but you should be able to find something he will like and tolerate.

Testing is hard for just about everyone at first, but it does get easier. The trick is to remain calm and not add to the cat's stress. The pain is very minor and their ears actually toughen over time so they don't even notice it. I used to test Cinco when he was sleeping and he didn't even wake up!
 
lovemycat444 said:
Taco has not been allowed to have treats bc of his potential food allergy he was on a strict diet of only the selected protein vet prescribed Royal Canin food.
Click to expand...
My Charlie couldn't have treats either. I prepped his meal then tested right before I put it down. In that sense, the meal became the "treat."

Tubby was on RC Select Protein due to other medical issues. I believe it's a higher carb food but sometimes you have to prioritize another disease and work the insulin around the higher carb. If Taco likes the RC food, you can make "treats" out of the canned by baking tiny morsels, or feed a kibble or two of the dry if that entices him.

lovemycat444 said:
Also, I'm upset to read that it could be causing him pain? The vet and so many other sources said he wouldn't feel any pain from the ear prick test.
Click to expand...
Ears are highly vascular (lots of blood vessels) but don't have a ton of nerve endings, so the ear prick really shouldn't "hurt." I've tested loads of cats over the years (including many non-diabetics) and I get the sense that the ones who dislike it are reacting mostly to either being restrained, having their ears messed with in general, or the click of the lancing device. I've even tested dogs. As long as you're pricking along the edge of the ear, you really shouldn't be causing much pain, so please don't let that deter you from testing.

Yes, most of us here hometest regularly, usually several times a day. I've known a few members who have tested a diabetic cat multiple times a day for 14 years or longer, so it can definitely be done with no adverse effect.

It's really important to collect data so you can see what's going on with Taco, keep him safe, and make the best decisions for him. Every cat is different, but a few general rules apply... one of which is that home testing saves lives. I've been sitting in the Vet Clinic ER more than once when a crashing cat comes in and have talked to the distraught owner. It's heartbreaking as is, but even more so because it's so darn preventable.

Your current insulin dose is pretty hefty given that, according to your sig line, it was based primarily on a high fructosamine result, so I really encourage you to get this testing thing down asap. Maybe tell Taco that you're very sorry but that the tests are necessary, then just do it, just like you would if you had to give your kid critical medicine. Don't hesitate. It really does get easier over time!
 
lovemycat444 said:
So it's been very hard to get him to be not utterly traumatized by the ear prick test, he absolutely hates it.
Click to expand...
Always test in the same spot at home (we tested on a futon in my office). Offer a treat every time you poke his ear regardless of whether it was successful or not. Before you know it, he will be jumping up to meet you at your testing spot.
 
Sandy and Black Kitty said:
Always test in the same spot at home (we tested on a futon in my office). Offer a treat every time you poke his ear regardless of whether it was successful or not. Before you know it, he will be jumping up to meet you at your testing spot.
Click to expand...
All of this!
My Cameron loathed it at first, but within a few days he tolerated it, and now as soon as he hears me heat up the rice sock he comes sauntering in and heads for the testing spot - as does our civvie cause he knows it's treat time for cats ;)

Make sure you're always giving a treat after, even the unsuccessful attempts.
 
Before we started ear pricks, we established a routine. Every morning, he gets tested (ear prick) around 7:15AM and then he immediately gets his canned food. (He never gets canned food unless after an ear prick.) Then, while he's eating, we prep and administer insulin (AMPS at 7:30am). Because he associates the ear prick with the food, he tolerates it well. In between, I was able to come home from work to test at +6 (1:30pm), do the PMPS at 7:30pm (test, canned food, shoot insulin), and then in the evening at +4 (11:30am) for a total of 4 tests a day. Everything is logged in the spreadsheet. I only tested more when he was getting very low numbers, indicating the need for a decrease in a dose. I always massage the ear first and use the 26 gauge ReliOn lancets freehand.

The lancet device doesn't work on cats because (in my experience) it pokes in the wrong spot (too low) and makes a loud, scary click! I poke him on the kitchen counter while holding him with my body so that he feels safe and also can't move. I also poke the ear from behind his head so he doesn't have to see what I'm doing (even though he knows...). The trick is to only poke in the sweet spots and rotate between ears. You can read the Struggling with ear pricks thread to find other tricks and tips from people who have unique ways of doing the testing. Ha-ha. Here's a pic you'll see in those threads that shows you the sweet spots:
ear_001-jpg.37102


So far, we're on Day 92 past diagnosis and now on Day 10 of an OTJ trial. But everyone's correct that you shouldn't shoot insulin without regular blood glucose testing. Also, you should read this sticky thread on TIGHT REGULATION which includes info on a hypo kit (you must have one). You can also print that post out and show it to your vet if you're feeling like sharing the love. :)

Good luck & keep engaging so that you can start regulating your kitty.
 
Sandy and Black Kitty said:
Always test in the same spot at home (we tested on a futon in my office). Offer a treat every time you poke his ear regardless of whether it was successful or not. Before you know it, he will be jumping up to meet you at your testing spot.
Click to expand...
thank you so much. but, won't the treat affect his blood glucose and give an inaccurate reading for the next test? I tested him every hour for 5 hours. Now (very new info) vet says he can go off the selected protein diet (for very bad potential food allergies) now he can have treats but I"m wondering if it affects the blood sugar? thank you!!
 
JL and Chip said:
My Charlie couldn't have treats either. I prepped his meal then tested right before I put it down. In that sense, the meal became the "treat."

Tubby was on RC Select Protein due to other medical issues. I believe it's a higher carb food but sometimes you have to prioritize another disease and work the insulin around the higher carb. If Taco likes the RC food, you can make "treats" out of the canned by baking tiny morsels, or feed a kibble or two of the dry if that entices him.

Thank you so so much for all of this info. !!



Ears are highly vascular (lots of blood vessels) but don't have a ton of nerve endings, so the ear prick really shouldn't "hurt." I've tested loads of cats over the years (including many non-diabetics) and I get the sense that the ones who dislike it are reacting mostly to either being restrained, having their ears messed with in general, or the click of the lancing device. I've even tested dogs. As long as you're pricking along the edge of the ear, you really shouldn't be causing much pain, so please don't let that deter you from testing.

Yes, most of us here hometest regularly, usually several times a day. I've known a few members who have tested a diabetic cat multiple times a day for 14 years or longer, so it can definitely be done with no adverse effect.

It's really important to collect data so you can see what's going on with Taco, keep him safe, and make the best decisions for him. Every cat is different, but a few general rules apply... one of which is that home testing saves lives. I've been sitting in the Vet Clinic ER more than once when a crashing cat comes in and have talked to the distraught owner. It's heartbreaking as is, but even more so because it's so darn preventable.

Your current insulin dose is pretty hefty given that, according to your sig line, it was based primarily on a high fructosamine result, so I really encourage you to get this testing thing down asap. Maybe tell Taco that you're very sorry but that the tests are necessary, then just do it, just like you would if you had to give your kid critical medicine. Don't hesitate. It really does get easier over time!
Click to expand...


Thank you I really appreciate all the info. such a relief to hear about the ear not being painful. Yes, I've pricked along the outer vein, and the sweet spot .
 
Chris & China said:
The AMPS is the AM Pre-Shot....the test you should get before feeding/Shooting in the morning.

PMPS is the PM Pre-Shot

U is for Units ….how much you give

After the AMPS, you start the "+ cells"......each cell corresponds to the number of hours since the last shot.....so if you shoot at 11am and get a test at 2pm, that's 3 hours after the shot, so the test number would go in the +3 cell....if you tested again at 6pm, that's 7 hours after the shot, so would go in the +7 cell......it goes all the way up to +11 and then the next cycle starts and it all starts over!!



We don't suggest going quite that fast....If you need to work your way back to a certain time, we suggest doing it 15 minutes per cycle or 30 minutes per day



Normal blood glucose for cats is 50-120 on a human meter....68-about 150 on a pet meter. Most vets will want you to keep them higher though because of their fear of hypoglycemia, but as long as you're testing, you are in control!!
Click to expand...



thank you so so much for all this info!!
 
since 4 units is a high dose of Lantus ,what is a normal dose? Can you please let me know (if you know this) thank you !!
 
lovemycat444 said:
since 4 units is a high dose of Lantus ,what is a normal dose?
Click to expand...

There's really no such thing as a "normal" dose......each cat needs as much as it needs, be it .5 or 50!

Unfortunately, without seeing a spreadsheet on Taco, there's not much helpful advice we can give you. We're very data driven here so we really depend on seeing the numbers.

Generally speaking, most cats start out at about 1U and increases are made in .25 unit increments based on the results you're getting.

If you need some help getting your spreadsheet going, I'd be happy to help you. Just send me a private message by clicking on my name and choosing "start conversation"
 
The correct dose for a cat is the one that works for that cat, at that particular point in time. My Neko's right dose varied from 8.75 units to 0.25 units over the space of five years. The only way I knew whether I should be going up or down in dose was by testing..
 
Ok, thanks. I've been completely overwhelmed and scared to do his BG testing before every meal bc he hates it so much, also bc I have to find someone to hold him. With that said, I'm going to try my best to learn how to get him to not be so terrified of the testing. (with all the great tips and info from people and yourself on this forum). I don't want to risk him having a hypo. Also, people and yourself have been so kind to send the link to the how to do the spreadsheet. I'm sorry to ask, would you please be able to send me the link here again? I've had a very hard time understanding it and how to do the spreadsheet. I'm going to read the info and ask a friend to help me. He's going to the vet tomorrow for Fructosamine testing. He has a new vet, the old one left the practice. He's had high BG numbers, has been drinking water excessively and has been hiding under the bed, so I am very concerned about him and want to have more info on how his bg is . Thank you so so SO much.
 
Wendy&Neko said:
The correct dose for a cat is the one that works for that cat, at that particular point in time. My Neko's right dose varied from 8.75 units to 0.25 units over the space of five years. The only way I knew whether I should be going up or down in dose was by testing..
Click to expand...
That's interesting to know and helpful thank you!
 
oh thank you so much! ok. I'm going to read the instructions now. it was very hard for me to understand last time, I think bc I'm terrible at math and excel. I am going to ask a friend to help me read it this weekend, my friend is a nurse so can prob help me. Or, I will ask my Mom to help me understand how to do this. Thank you so much!
 
You don't need math and it's a Google spreadsheet, not excel.....it's already formatted.....all you have to do is enter the numbers!!

It really is very easy!!

(well, the only math you need is to be able to count how many hours it's been since your last shot....LOL)
 
lovemycat444 said:
That's interesting to know and helpful thank you!
Click to expand...
It's important to keep in mind that insulin needs can and do change over time-that's why we call it the Sugar Dance. Two steps forward, one step back..sometimes a cha-cha, sometimes a Tango...
It is indeed a dance and your kitty is leading

Each kittys dance has its share of ups and downs.

Ours was a bit...extreme however it illustrates how things can change :cool:
BK insulin graph (600x337).jpg
 
You must log in or register to reply here.
Back
Top